DR. JEFFREY ERVIN MANGUS (NPI# 1063661270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063661270 |
| Entity Type | Individual |
| Full Name | DR. JEFFREY ERVIN MANGUS |
| Credential | PHARM.D. |
| Practice Address |
3900 Capitol Mall Dr Sw Olympia WA 98502-8654 |
| Mailing Address |
10049 Lookout Dr Nw Olympia WA 98502-9713 |
| Practice Telephone | 3609562559 |
| Mailing Telephone | 3609562559 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
PH00018280 | WA | Pharmacy Service Providers |
| Street Address |
3900 CAPITOL MALL DR SW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-8654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316933666 | Laurinda Rae Elgin | Nurse Practitioner | 3900 Capitol Mall Dr Sw, Capital Medical Center - Womens' Services, Olympia, WA 98502-8654 | 2005-09-22 |
| 1831476977 | Eli Staker | Nurse Anesthetist, Certified Registered | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2011-11-03 |
| 1083993117 | Heather Lynne Grant | Pharmacist | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2011-08-07 |
| 1649579699 | Richard Bitangcol Tolentino | Audiologist | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2011-03-16 |
| 1760785281 | Capital Medical Center Specialty Physicians, LLC | Urology | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2010-12-07 |
| 1285936229 | Capital Hospitalists | General Acute Care Hospital | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2010-11-24 |
| 1265764567 | Elizabeth K Couture | Nurse Anesthetist, Certified Registered | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2010-02-11 |
| 1053550384 | Marvin Abbott | Pharmacist | 3900 Capitol Mall Dr Sw, Capital Medical Center Pharmacy, Olympia, WA 98502-8654 | 2009-02-10 |
| 1760635908 | Fred Martin Ames | Pharmacist | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2008-10-31 |
| 1558526756 | Thurston Emergency Group A Professional LLC | Physician Assistant | 3900 Capitol Mall Dr Sw, Olympia, WA 98502-8654 | 2008-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647506 | William Kyle Davis | Pharmacist | 305 Cooper Point Rd Nw, Olympia, WA 98502-4436 | 2020-07-23 |
| 1578012142 | Kristine Gillas | Pharmacist | 413 Lilly Rd Ne, Olympia, WA 98506-5133 | 2016-09-23 |
| 1326442609 | Randy Kent Pair | Pharmacist | 1313 Cooper Point Rd Sw, Olympia, WA 98502-5729 | 2014-10-15 |
| 1114157146 | Mi Ni Paek | Pharmacist | 700 Lilly Rd Ne, Olympia, WA 98506-5115 | 2009-07-24 |
| 1154586576 | Janet Elaine Schade | Pharmacist | 3900 Capital Mall Dr Sw, Olympia, WA 98502-5026 | 2008-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891395760 | Evelyn Tong | Pharmacist | 4229 122nd Ave Se, Bellevue, WA 98006-1915 | 2020-10-29 |
| 1356985345 | Nancy Celine Tran | Pharmacist | 906 S 38th Ct, Renton, WA 98055-5897 | 2019-11-01 |
| 1265087654 | Valorie Swensen | Pharmacist | 4500 Harrison St, Bellingham, WA 98229-3323 | 2019-08-02 |
| 1982110805 | Derek Matlock | Pharmacist | 3715 Ocean Beach Hwy # 2, Longview, WA 98632-4801 | 2017-12-15 |
| 1659880938 | Hazel Ann Feist | Pharmacist | 14406 Nw 20th Ave, Vancouver, WA 98685-8007 | 2017-09-29 |
| 1528586732 | Mayumi Robbins | Pharmacist | 410 9th Ave N Fl 7, Seattle, WA 98109-4708 | 2017-09-07 |
| 1699293688 | Jin Man Choe | Pharmacist | 105 W 8th Ave Ste 350, Spokane, WA 99204-2312 | 2017-08-30 |
| 1821457813 | Marie Cermak | Pharmacist | 12333 Ne 130th Ln # Lane415, Kirkland, WA 98034-7467 | 2016-02-18 |
| 1902281959 | Carmen Joy Berg | Pharmacist | 2320 South Salnave Road, Medical Lake, WA 99022 | 2015-07-20 |
| 1639574981 | Loi Chau | Pharmacist | 601 Broadway Rm 117, Seattle, WA 98122-5330 | 2014-10-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.